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May 2018 MedCity News

The recent AAA 2018 convention in Nashville offered some examples of how the worlds of consumer listening devices and hearing aid technology are colliding.  New hearable devices—earbuds and earphones which contain the familiar functionality of streaming music and phone calls from smartphones—also augment users’ hearing.  Hearables’ self-fitting technology and options for customisation empower consumers to manage their listening experience, at attractive prices. But hearables have one downside — their unwieldy form factors.

At the Nashville convention, attendees crowded into Bose’s booth for a demo of its “Hearphones”. Nuheara also offered a preview of its new IQbuds BOOST earbuds.  Attendees donned the hearables and manipulated the accompanying apps to hear better in noisy environments and modify preset listening modes, guided by the apps’ illustrative graphics.

“We’re trying to make this very easy to understand,” said David Cannington, Nuheara’s co-founder.

Unlike traditional hearing aids, hearables are not FDA-approved medical devices. Referred to as personal sound amplification products (PSAPs), hearables accentuate sounds in specific listening environments for non-hearing impaired consumers. Mike Kratochwill, Bose Hear head of marketing and product management, described Bose’s market as people who want to hear better in noisy environments.   Nonetheless, Bose and Nuheara attended AAA 2018 to woo audiologists, clinical professionals who administer hearing tests, recommend hearing aids, and fit devices.   “We’re here to share Hearphones with audiologists to expose them to our product,” said Kratochwill. Audiologists will need to determine how to integrate hearables’ lower price points with their business model.  Traditional hearing aids with smartphone connectivity retail for about $5,800 a pair. In contrast, Bose Hearphones and a pair of Nuheara’s IQ Buds BOOST both retail for $499.

Hearables point to the potential convergence of traditional hearing aids with consumer product audio devices. The passage of the Over-the-Counter (OTC) Hearing Aid Act of 2017 will no doubt hasten that convergence.  The Act instructs the U.S. Food and Drug Administration to create a class of OTC hearing aids for people with mild to moderate hearing loss. The FDA must propose regulations within three years of enactment.  By 2020, close to 45 million people in the United States will suffer from mild to moderate hearing loss, with 20 million of them aged 20 to 69, according to a study published by JAMA.  Yet traditional hearing aids have low adoption, with the penetration rate as low as 14 percent by some estimates.  

Hearables stand out in the level of empowerment they offer to users. The six worldwide premium hearing aid brands—Oticon, Phonak, Resound, Signia, Starkey, and Widex—now link to smartphone apps which offer customisation. Users may toggle between pre-set listening programs, adjust volume, treble, and bass on the fly, and in some cases change the relative contribution of sound between the hearing aid (sounds from the outside world) and the smartphone. Yet the hearables provide users with additional options for managing the listening experience. With Nuheara’s product, users’ control of the device happens immediately, with the hearing assessment used to calibrate the earbuds.  Nuheara’s “Ear ID” assessment is deftly labeled (no one likes a test!) and easy to take: users tap a large blue button the screen when they hear a tone. Results appear in color-coded, concentric rings. Instead of displaying the frequency numbers utilized on traditional audiograms—incomprehensible to many–the app labels sounds from “bird chirping” to “plane rumbling.”

Nuhearing TestIQbuds BOOST hearing assessment results screen by Nuheara

The Bose Hearphones forgo the hearing assessment to allow users to adjust sound.  The World Volume dial allows users to control sound in the external environment, such as people’s voices. Moving the dial above zero slowly amplifies the conversation.  “But scrolling up on the dial isn’t simply making all sounds louder,” clarified Ben Parker, Bose Hear product manager. “We are increasing quiet sounds more than loud sounds, so that all sounds can be heard but none are uncomfortable.”  In other words, the Hearphones address hearing in noisy environments, a difficulty for many people. Dialing below zero reduces sound in the environment. At -50 on the dial, “there is full noise cancellation,” explained Parker, “providing the same comfort level as traditional Bose headphones.”

Users of Nuheara’s earbuds may also make real-time adjustments to volume levels and save their preferences for different external environments.  The IQbuds BOOST SINC wheel, for example, lets users adjust the amount of background noise cancellation.

For older adults in prime-working years, the prevalence of hearing loss is surprising: 23% of US  adults aged 50 to 59 have a hearing loss that impacts understanding of speech, according to a JAMA study.  Working adults struggle to communicate with passengers while driving a ride-share car, handle conference calls in the office and inquiries in the call centre, and hear colleagues around a large conference table.  Are hearables suitable for work?  The Nuheara earbuds bulge noticeably from the ears, and Bose earphones loop prominently around the neck.

“Ask Apple that question!” declared Nuheara’s Cannington, referring to the Air Pods. “Apple has made it socially acceptable to wear strange things hanging out of your ear.”

Yet hearables users may need to provide some explanation.  Otherwise, they risk telegraphing inattention to their customers or colleagues.  “That’s the paradigm shift, wearing this product and yet signaling that you’re available,” says Kratochwill. “The decision has to do with an individual’s company culture, the job they’re doing, the individuals themselves.”

For at least some users, the form factors may be acceptable given these devices’ customisation options at attractive prices.  Hearables demonstrate how consumer listening devices and traditional hearing aid technology are colliding to improve consumers’ hearing experience. Tailored amplification, noise reduction, phone calls, and music listening now come packaged in one device, customisable with a smartphone app.

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